Individual
JEANNA SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 CLEVELAND AVE N, ROSEVILLE, MN 55113-1126
(651) 642-1825
Mailing address
2800 CLEVELAND AVE N, ROSEVILLE, MN 55113-1126
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
R 190838-9
MN
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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